Care homes accused of failing the dying

Fewer than 1% of care homes have revised their procedures for looking after dying people despite new guidelines issued a year ago to give the terminally ill greater control over the final stages of their lives.

A government evaluation today concludes that people dying in care homes are missing out on the improvements because the homes operate largely outside of NHS control. Ian Philp, the tsar for older people, found 8%-10% of the 500,000 deaths every year in England occur in care homes but their experiences are often "invisible" to the outside world.

Tomorrow, Help the Aged will publish a study of the views on palliative care of NHS hospital managers, doctors and nurses. It is expected to say that many feel they are too stretched to offer a "good quality" death and that a significant proportion of hospitals do not even have a policy on how to care for dying people.

Today's report measures the success of a £12m three-year NHS end of life care programme a year after it was introduced. It sets out the gold standard treatment for the last months of a person's life, a new model for involving families in decisions before death and a new written statement patients can make about where they wish to die.

The evaluation shows that 60% of hospitals have at least one ward adopting one of the three key promises, up from 50% at the beginning of the project. But only 47% of hospices, 11% of community hospitals and 0.75% of care homes have introduced one of the schemes - up from 36%, 9% and 0.3% respectively. Some 21 of the 28 health authorities surveyed named care homes as the biggest area for improvement.